ROSE Procedure, a weight loss revision surgery

Traditionally those who needed a revision bariatric surgery following a gastric bypass (also known as Roux-en-Y procedure) have had to resort to another open or laparoscopic gastric bypass surgery involving more cutting of the internals of the body. Such a revision obesity surgery is quite complicated and therefore surgeons and patients frequently avoided it for the high risks associated with it.

Today patients have a better choice which not only involves NOT opening up the patient, as it is done edoscopically, but is also less complicated and has minimal risks.

Need for the ROSE procedure

The ROSE procedure is a weight loss surgery (WLS), needed as a revision for a gastric bypass surgery. So let’s first understand what a gastric bypass procedure does.

The aim of a gastric bypass surgery is to make the stomach and stoma very small so that the stomach can now hold much less food and the feeling of satiety is achieved after the consumption of a very small amount of food. This makes the person eat less and thus lose weight.

Most people lose their excess weight to a great extent following a gastric bypass procedure. However, the stomach pouch and the stoma may expand/stretch over time causing the capacity of the stomach to increase. So the stomach can now hold more food and the feeling of fullness is now achieved after consumption of a larger amount of food than before. This results in weight regain.

A revision weight loss surgery is therefore required to once again reduce the size of the stomach pouch and the stoma. The ROSE (Restorative, Obesity Surgery, Endolumenal) procedure is a revision weight loss surgery for patients who have had gastric bypass surgery previously (at least 2 years ago) and lost 50% of excess weight but regained at least 15% of it back.

In a ROSE procedure, the surgeon pleats/folds the stomach with sutures to reduce its size back to about the size at the time of the original gastric bypass surgery. This is achieved through an endoscope (a long narrow tube carrying a camera and surgical instruments) which the surgeon inserts into the patient’s stomach pouch through a natural opening in his body, in this case his mouth and down the esophagus. The surgical tools in the endoscope are then used to gather together sections of stomach tissue to create a pleat which is then sutured together. With this process, the stomach volume and stoma diameter can be reduced to increase restriction and help weight loss. The procedure takes about an hour to complete.

Candidacy for the ROSE procedure

In order to be eligible for the ROSE surgery you must have:

had the gastric bypass procedure at least 2 years ago,

lost 50% of your excess body weight following the surgery, and

regained 15% of it back.

In some cases, a patient may also be a candidate if he underwent gastric bypass surgery but failed to lose weight.

Advantages of the ROSE procedure

Incisionless i.e. no external incisions or cuts therefore lower risk of infection and associated complications, and also no scarring

Quick procedure (takes about an hour)

Causes little or no discomfort to the patient

Minimal post operative pain/symptoms (mild sore throat, hoarseness, swollen lip, and lip pain due to the endoscopic instruments that were inserted into the mouth)

Whether you are 18 years old or 74 years old, living with a bad set of teeth is like going through a living hell. But, thanks to the miracles of modern dentistry, now dental patients can turn their horrible experiences into life-changing ones – and that too at an affordable price.

A post recently appeared in the Wall Street Journal Blog which talked about Healthbase, Healthbase’s customers and the latest trend in medical tourism or global healthcare – traveling from one state to another within the United States in search for cheaper prices for major surgeries. Healthbase is one company that has been helping American patients connect to affordable hospitals in the US for major surgeries. The author writes,

Uninsured Americans also are shopping around for surgery in the U.S. in record numbers, and using new services such as Healthbase Online Inc. , a Boston-based medical brokerage that arranges treatments for patients at health-care facilities worldwide. Rodney Larson, a self-employed electrician from Minnesota, used Healthbase Online to arrange a triple heart bypass at Galichia Heart Hospital in Wichita, Kansas. He paid $13,000 flat fee for the surgery, about $90,000 dollars less than the rate for uninsured patients in Minnesota.

The current economic conditions…

Worsening economic conditions have made employers and workers more inventive in dealing with ever-rising health-care costs. Some are taking advantage of new health services that offer fixed rates for surgery to patients willing to travel to get care.

The financial benefits of domestic and international medical tourism cannot be overlooked and some insurers have taken active steps to reduce the health care costs for their clients in this slowing economy by offering them medical tourism options. The author mentions about the forward thinking by some health insurers and writes,

Others insurers aren’t sold on asking customers to travel for health care. Aetna Inc. says it already negotiates significant discounts with medical providers. Typically, it pays physicians within three days of submitting a claim, so up-front cash payments aren’t a strong incentive for achieving additional discounts, according to a company spokesperson.

The health insurer Wellpoint is testing a new program that gives covered patients the option of going to India for elective surgery, with no out-of-pocket medical costs and free travel for both the patient and a companion.

The program is being tested at Serigraph, a printing company in Wisconsin whose managers have been looking for ways to curb rising health care costs, said Dr. Razia Hashmi, chief medical officer for national accounts for Anthem Blue Cross and Blue Shield, which is affiliated with Wellpoint.

“This is a first for us,” Dr. Hashmi said. “We will be monitoring every aspect of this very closely, to make sure everyone is satisfied and there are good clinical outcomes.”

By the year 2010, more than 6 million Americans annually will be seeking medical treatment abroad , according to the Deloitte Center for Health Solutions, a consultancy. The potential savings are significant. Knee surgery that costs $70,000 to $80,000 in the United States can be performed in India for $8,000 to $10,000, including follow-up care and rehabilitation, Dr. Hashmi said. Similar savings could be achieved for such common procedures as hip replacements and spine surgery .

If other insurers follow Wellpoint, Dr. Hashmi said, the trend ultimately may pressure on United States hospitals to be more competitive in their pricing.

Critics say that’s unlikely.

“There have been some reports of hospitals that have been willing to match the prices, but I don’t know how they’re doing that,” said Howard Berliner, a professor of health policy and management at State University of New York Downstate Medical Center in Brooklyn. “The reality is there’s just no way that most hospitals can respond to this. It’s just like any service that’s outsourced – the price is so cheap abroad that there isn’t much an American company can do about it.”

At the same time, he said, the program could potentially siphon off the healthiest, most profitable patients from a local hospital.

Dr. Hashmi predicted that the program would appeal primarily to people who have traveled abroad. Many employees of Serigraph, which has offices in India, are familiar with the country.

“The quality is comparable” to care provided in the United States, Dr. Hashmi said. All the physicians speak English, and patients can share their medical records and consult with a surgeon in India before making the trip, she said.

The pilot program arranges for patients to be picked up at the airport and provides special meals to prevent food-borne illnesses. The program complies with the American Medical Association guidelines on medical tourism and uses hospitals accredited by the Joint Commission International.

Dr. Hashmi said it had actually been easier to evaluate the quality of medical care abroad than in the United States. “There is a lot more willingness to share data about complication rates, the total number of procedures and the outcomes,” Dr. Hashmi said. “We’re able to get detail per hospital and per physician.”

In addition to saving out-of-pocket costs for surgery for patients, the program could potentially help keep insurance premiums affordable, Dr. Hashmi said.

Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

SEPTOPLASTY

The surgical procedure to treat problems associated with a crooked or deviated nose, such as chronic sinusitis, inflammation, bleeding, or sleep apnea, is termed septoplasty.

Septoplasty, submucous resection of the septum, or septal reconstruction is a corrective surgery to straighten or repair a deviated nasal septum – the wall between the two nasal passages. Usually the septum is straight and upright, and runs down the center of the nose. A deviated septum occurs when the cartilage or bone of the septum is not straight, thereby narrowing the cavity into which is deviates making breathing difficult. This condition can lead to snoring and sleep apnea, and in certain serious deviations may frequently lead to chronic sinus problems.

Septoplasty is necessary only when the problems associated with crooked nasal septum do not get better without surgery. The surgery may be done along with other procedures to treat chronic sinusitis, inflammation, or bleeding, or to correct sleep apnea. The procedure also may be done to allow access into the nose to remove nasal polyps.

DETAILS OF THE PROCEDURE
The procedure usually involves an excision or cutting of a portion of the cartilage and/or bone surplus. Under general or local anesthesia, the surgeon works through the nostrils, making an incision in the lining of the septum to reach the cartilage targeted in the operation. Often an “L” strut of cartilage in the dorsal and caudal areas (1cm width or more) is preserved for structural support. After excess cartilage and bone have been taken out, the septum may then be stabilized with small plastic tubes, splints, or sutures. The operation takes about 60-90 minutes.

AFTER THE SURGERY
Considerable swelling and bruising can be expected. The nasal cavities may or may not be packed, and a piece of gauze is taped underneath the nose to absorb blood. Postoperative care includes frequent changing of this gauze (roughly every hour or so) and after 1 to 2 days, the excess bleeding normally stops and the inner nasal packing may be removed. The following day, saline irrigations of the nasal cavities are often advised, and the patient may be allowed to gently blow their nose. After 1 to 2 weeks, patients are allowed to blow their nose normally. Patients typically regain about 80% of their energy one week after the surgery.

COST OF SEPTOPLASTYRegister to Healhtbase to request a FREE quote for affordable septoplasty surgery.

Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

UVULOPALATOPHARYNGOPLASTY

Uvulopalatopharyngoplasty, UPPP or UP3 is the surgical removal of tissue in the throat to widen the airway. It is a surgical procedure to cure problems such as snoring and obstructive sleep apnea. The following tissues may be removed through uvulopalatopharyngoplasty:
• The uvula (small fingerlike piece of tissue that hangs down from the back of the roof of the mouth into the throat)
• The soft palate (part of the roof of the mouth )
• The tonsils (any collection of lymphoid tissue)
• The adenoids (a mass of lymphoid tissue situated at the very back of the nose), and
• The pharynx (the part of the neck and throat situated immediately posterior to the mouth and nasal cavity).

Another procedure to treat snoring is laser-assisted uvulopalatoplasty.

Cost of Uvulopalatopharyngoplasty
Snoring is not always considered a medical problem, so insurance may not cover treatment. For affordable uvulopalatopharyngoplasty or laser-assisted uvulopalatoplasty surgery overseas, register to Healthbase.

Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

007 TOP SECRETS OF MESSING UP YOUR MEDICAL CARE OVERSEAS

Ever heard of botched cosmetic jobs in Brazil or crappy dental work in Mexico? Such situations are very real. Here are the 007 top secrets of messing up your medical care overseas.

Top Secret # 001: Not doing research
Don’t do any research and you will successfully fail in your quest for achieving safe and healthy medical treatment overseas. However, if you do want to go abroad and get quality health care while saving some bucks then consider doing thorough homework and collecting enough information. Some sources of information are: websites offering medical tourism services like Healthbase, news, articles, testimonials, etc. Satisfied medical tourists claim proper research to be a sure-fire way of happy and healthy medical tourism.

Top Secret # 002: Going abroad for a wrong procedure
Your ambulance will not drive you to India during an emergency (or even otherwise). Reasonably, only non-emergency treatments can be considered for medical tourism but not all such treatments fit the criterion as sometimes the travel costs can outweigh the possible savings achievable by going abroad.

Top Secret # 003: Choosing the wrong place
How about going to Thailand for your half-yearly dental cleaning? Superb idea? Not exactly. How about going there for dental implants? Maybe. And for full mouth restoration? Definitely. Choose a wrong place and you will waste your money on medical tourism instead of saving some. Wise medical tourists consider travel cost, lodging cost and number of visits required for full treatment when calculating potential savings.

Top Secret # 004: Choosing an unqualified doctor
Thanks to the power of the Internet, it’s very easy to choose a doctor qualified at accomplishing botched jobs. If you wish to not fall prey to them, better do your homework properly. Check your doctor’s credentials, ask people around and get recommendations from reliable sources to avoid scheduling an appointment with “Dr. Quack”.

Top Secret # 005: Not doing proper planning and preparation
Allowing time for surgery but not for recovery and recuperation? That will require you to modify your itinerary. As a medical tourist you should prepare yourself to stay longer/shorter than expected. If you have travel or tourism on mind, allow time for that as well. A word on arranging your essential documents: Put together your medical records and financial records, acquire passport and visa, and have the information of your important contacts handy. Also, book your travel tickets and hotel rooms well in advance.

Top Secret # 006: Working with a substandard medical tourism agency
There are new agencies cropping up each day. Some of them are there to genuinely help you while others are affiliated with “Dr. Quack”. A good medical tourism agency like Healthbase will have partners that are certified by international or domestic accrediting organizations. It will offer a variety of medical travel services, it will offer numerous medical procedures in many countries, it will have patient testimonials on its website, it will have been covered by media, and much more. Your research will help you identify the good ones.

Top Secret # 007: Failing to follow the right aftercare
Planning to play football the day after your total knee replacement surgery? Ouch, that will hurt! Physical therapy, rest, diet, medication, etc. are all as important as the surgery. Your local doctor might be able to help you with your aftercare so always keep him informed. You might also need his help, for example, for removing sutures or for taking X-Rays.

Remember to avoid the above 7 mistakes and your medical tourism abroad will be happy, healthy and successful.

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